Breast cancer patient experiences of perioperative distress and anxiety: A qualitative study

Bronwen Grocott; Kristin Reynolds; Gabrielle Logan; Pamela Hebbard; Renée El-Gabalawy

doi:10.1016/j.ejon.2023.102299

Breast cancer patient experiences of perioperative distress and anxiety: A qualitative study

Eur J Oncol Nurs. 2023 Apr:63:102299. doi: 10.1016/j.ejon.2023.102299. Epub 2023 Feb 17.

Authors

Bronwen Grocott¹, Kristin Reynolds², Gabrielle Logan³, Pamela Hebbard⁴, Renée El-Gabalawy⁵

Affiliations

¹ Department of Psychology, Faculty of Arts, University of Manitoba, Canada; Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada.
² Department of Psychology, Faculty of Arts, University of Manitoba, Canada; Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada.
³ Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada.
⁴ Department of Surgery, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada; CancerCare Manitoba, Canada.
⁵ Department of Psychology, Faculty of Arts, University of Manitoba, Canada; Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada; Department of Psychiatry, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada; Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Canada; CancerCare Manitoba, Canada. Electronic address: renee.el-gabalawy@umanitoba.ca.

PMID: 36893576
DOI: 10.1016/j.ejon.2023.102299

Abstract

Purpose: Distress, often manifesting as anxiety, is common in breast cancer patients and becomes particularly elevated before surgery. This study investigated perspectives of those undergoing breast cancer surgery concerning what enhances and reduces distress and anxiety across the perioperative period (i.e., from diagnostic evaluation to recovery).

Methods: The present study conducted qualitative semi-structured individual interviews with 15 adult breast cancer surgery patients within three months post-operation. Quantitative surveys provided background information (e.g., sociodemographics). Individual interviews were analyzed using thematic analysis. Quantitative data were analyzed descriptively.

Results: Four main themes emerged from qualitative interviews: 1) "fighting an unknown" (sub-themes: uncertainty, health-related knowledge and experience); 2) "the cancer takes away the control" (sub-themes: "living at the whim of others", trusting care providers); 3) person at the centre of the patient (sub-themes: "managing life:" caregiving and work-related stressors, "everybody jumped in to help:" emotional and instrumental support); and 4) physical and emotional impacts of treatment (sub-themes: pain and impacted mobility, "losing a part of yourself"). Breast cancer patients' experiences of surgery-related distress and anxiety were contextualized by broader experiences of care.

Conclusions: Our findings illustrate the illness-specific experience of perioperative anxiety and distress in breast cancer patients and inform patient-centered care and intervention.

Keywords: Anxiety; Breast cancer; Distress; Perioperative; Qualitative; Surgery.

MeSH terms

Adult
Anxiety
Anxiety Disorders
Breast Neoplasms* / psychology
Emotions
Female
Humans
Patient Outcome Assessment
Qualitative Research